Sialendoscopy in the management of obstructive sialadenitis: clinical experience and treatment outcomes

BACKGROUND: Obstructive sialadenitis is a common salivary gland disorder. This retrospective study evaluated the outcomes of sialendoscopy in 90 patients treated between July 2018 and December 2023. OBJECTIVE: To evaluate the success rate, complications, and predictors of treatment outcomes of sialendoscopy in patients with obstructive sialadenitis. DESIGN: Retrospective cohort study SETTING: Security Forces Hospital, Saudi Arabia PATIENTS AND METHODS: A retrospective cohort study was conducted using patient medical records. Patients with obstructive sialadenitis were included. MAIN OUTCOME MEASURES: Success of sialendoscopy, defined as complete endoscopic stone retrieval with confirmed ductal patency on post-retrieval irrigation. Four procedures in which no sialolith was identified intraoperatively were excluded from the stone-retrieval success denominator (n=94 stone-confirmed procedures). SAMPLE SIZE: Ninety patients RESULTS: Submandibular glands accounted for 74% (67/90) of cases. Success rates for complete stone retrieval were 79% (19/24 parotid) and 79% (55/70 submandibular). Key predictors of success included stone size, location, and number: stones >10 mm (OR=0.17, 95% CI: 0.04–0.67; P =.01), intraglandular location (OR=0.13, 95% CI: 0.03–0.54; P =.005), and multiple stones (OR=0.18, 95% CI: 0.05–0.60; P =.006) significantly reduced success. Complications occurred in 11.2% (11/98) of cases, primarily ductal stenosis and postoperative swelling, with submandibular glands contributing most complications. CONCLUSION: In this one of the larger reported single-centre Saudi series, sialendoscopy demonstrated high success for obstructive sialadenitis, with stone size >10 mm, intraglandular location, and multiplicity as independent failure predictors. These findings support tailored approaches in Middle Eastern populations. LIMITATIONS: Retrospective single-center design, lack of long-term follow-up data, and absence of patient-reported outcome measures.